LACRETIA BRAZZLETON (NPI# 1871004887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871004887 |
| Entity Type | Individual |
| Full Name | LACRETIA BRAZZLETON |
| Practice Address |
14447 S Bensley Ave Burnham IL 60633-2224 |
| Mailing Address |
17746 Oak Park Ave Tinley Park IL 60477-3936 |
| Practice Telephone | 7088620212 |
| Enumeration Date | 2017-10-17 |
| Last Update Date | 2017-10-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
14447 S BENSLEY AVE |
| City | BURNHAM |
| State | IL |
| Zip Code | 60633-2224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952465494 | Grand Prairie Services | Clinic/Center | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2006-12-20 |
| 1407321458 | Jasa Perry | Counselor | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2018-10-05 |
| 1851810436 | James Bryan | Case Manager/Care Coordinator | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2017-09-14 |
| 1245750710 | Kenon Harding | Case Manager/Care Coordinator | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2017-06-26 |
| 1295264976 | Daniel Brown | Behavioral Analyst | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2017-06-07 |
| 1205134483 | Cherita D Epps | Behavioral Analyst | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2011-03-11 |
| 1619271236 | Phillip Jackson | Behavioral Analyst | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2010-12-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154749513 | Ronald Paetsch I | Physical Therapy Assistant | 14500 S Manistee Ave., Burnham, IL 60633 | 2014-04-02 |
| 1033547914 | Sharron Lynese Mckee | Social Worker | 14545 South Manistee Ave., Unit 2c, Burnham, IL 60633 | 2013-10-31 |
| 1104437904 | Aracely Delreal | Counselor | 2753 E 127th St, Chicago, IL 60633-1128 | 2020-08-14 |
| 1790270965 | Emily Therese Opiola | Nurse Practitioner | 12816 S Muskegon Ave, Chicago, IL 60633-1243 | 2018-06-28 |
| 1144464322 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 3125 E 131st St, Chicago, IL 60633-1315 | 2009-05-01 |
| 1750468534 | James Egan | Chiropractor | 13101 S Baltimore Ave, Chicago, IL 60633-1318 | 2006-11-01 |
| 1194083766 | Joseph Pantano | Physical Therapy Assistant | 13002 S Brandon Ave, Chicago, IL 60633-1321 | 2012-05-02 |
| 1669039020 | Nikolina Medina | Speech-Language Pathologist | 13131 S Buffalo Ave, Chicago, IL 60633-1326 | 2019-05-21 |
| 1790811545 | Efstathia Maria Saranteas | Acupuncturist | 13144 S Buffalo Ave, Chicago, IL 60633-1327 | 2007-02-26 |
| 1972692812 | James M Goril | Dentist | 13247 S Baltimore Ave, Chicago, IL 60633-1431 | 2006-10-11 |
| Find all providers in zip 60633 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679902571 | Angela Deamer | Case Manager/Care Coordinator | 543 E Freedom Ave, Burnham, PA 17009-1306 | 2013-11-01 |
| 1851810436 | James Bryan | Case Manager/Care Coordinator | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2017-09-14 |
| 1245750710 | Kenon Harding | Case Manager/Care Coordinator | 14447 S Bensley Ave, Burnham, IL 60633-2224 | 2017-06-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740887157 | Forefront Healthcare Solutions, Inc. | Case Manager/Care Coordinator | 60 E Monroe St Unit 3801, Chicago, IL 60603-2751 | 2020-10-08 |
| 1205441698 | Desirae Mccrainey | Case Manager/Care Coordinator | 55 E Monroe St Ste 38109, Chicago, IL 60603-5713 | 2020-09-11 |
| 1871119966 | Nimble Corporation | Case Manager/Care Coordinator | 28369 Davis Pkwy Ste 403, Warrenville, IL 60555-3036 | 2020-06-24 |
| 1659993954 | Aubrey Williams | Case Manager/Care Coordinator | 1533 W Warren Blvd, Chicago, IL 60607-1852 | 2020-05-11 |
| 1154942449 | Keisha Davell Cole | Case Manager/Care Coordinator | 612 S Western Ave Unit 1, Chicago, IL 60612 | 2020-04-28 |
| 1720616063 | Amber Lynn Gille | Case Manager/Care Coordinator | 13262 Foxglove Ln, Winnebago, IL 61088-9012 | 2020-03-31 |
| 1467084897 | Lisa S Johnson | Case Manager/Care Coordinator | 510 Exeter Pl, Lake Forest, IL 60045-1521 | 2020-02-04 |
| 1073158085 | Danny Living | Case Manager/Care Coordinator | 1050 Freemont St, Yorkville, IL 60560-2074 | 2019-11-13 |
| 1235772864 | Rebekah Johnson | Case Manager/Care Coordinator | 208 E 87th St, Chicago, IL 60619-6040 | 2019-10-27 |
| 1558903161 | Isadora Borrero | Case Manager/Care Coordinator | 1850 W Highland Ave # F101, Elgin, IL 60123-5095 | 2019-10-15 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.